The Remote Effects of Gout
The Remote Effects of Gout is a letter written by Arthur Conan Doyle first published in The Lancet on 29 november 1884.
The Remote Effects of Gout
Sir, — I read with much interest the description of the relation of certain diseases of the eve to gout, as reported last week in the Lancet. Mr. Hutchinson has remarked in his lecture on the obscure non-arthritic effects which gout may produce in the children of gouty parents, without any ordinary gouty symptoms. I have had two cases lately in my practice which illustrate his remarks so well that 1 cannot forbear from quoting them. A Mr. H — came to me suffering from chronic eczema and psoriasis. He attributed it himself to the great changes of temperature and profuse perspirations incidental to his business. I put him on arsenic and afterwards on iodide of potash, without much benefit. He told me that he had never had any gouty symptoms in his life. Shortly afterwards his married daughter, Mrs. B —, consulted me on certain intense pains in her eyes, accompanied by temporary congestion and partial blindness, which attacked her whenever her digestion was deranged. Recognising this to be a gouty symptom, and bethinking me of the obscure skin disease which afflicted the father, I made somewhat minute inquiries into the previous family history. I then found that the grandfather of Mrs. B — and the father of Mr. H — had been a martyr to gout for many years, and had eventually died ofa form of Bright's disease, which I have no doubt from the description was the "contracted granular kidney" so intimately associated with gout.
These cases are, I think, interesting as showing the protean character of the disease, extending over three generations. The grandfather was thoroughly gouty; the father had skin affections without any other gouty symptom; the third generation exhibited eye symptoms and nothing else. I may mention that both cases improved rapidly upon calchicum and alkalies.
Yours sincerely,
A. CONAN DOYLE, M.B., C. M.
Southsea, Nov. 24th, 1884.
